Comprehensive Guide to Neck Lift and Neck Liposuction with Dr. Benjamin C. Stong

Any person desiring to improve the appearance of their neck is a neck lift candidate. The combination or variation on the procedure that is right for you will depend on your specific needs, which is carefully assessed during your consultation with Dr. Stong.

Patients with a long neck and a high and tight angle between the chin and neck (cervicomental angle) will ultimately have the best results from a neck lift procedure. The ideal neck should have a clear definition of the angle between the chin and neck. Excess skin, fat, and muscle banding, that develop as we age, creates a blunted cervicomental angle. This can be corrected during neck lift surgery to restore a more youthful appearance.

Submental liposuction is a mechanical procedure that removes fat from the neck using a small metal cannula that removes fat out as the rod is passed gently back and forth. Ideally submental liposuction is indicated for younger adults with an excess amount of fat under the chin and neck. As a person ages, fat removal options become limited because the skin loses elasticity and is less able to contract down and recreate the characteristics of a youthful neck.

A platysmaplasty is often part of a neck lift procedure and involves tightening of the platysma muscle with sutures. The platysma muscle is the circular muscle in the neck that acts as a corset for a smooth and contoured neck. As we age, the platysma muscle begins to stretch and separate in the midline, which results in bands. A platysmaplasty simply sutures the muscle together in the midline of the neck, creating a tightened and rejuvenated neck appearance. Depending on your specific concerns and needs, fat removal (liposuction or lipectomy) is most commonly added to a platysmaplasty when performing a cervicoplasty or submentoplasty neck lift.

A Neck Lift is often referred to as a submentoplasty or cervicoplasty. A neck lift often lasts around 1 hour as an isolated procedure, and is used to address the vertical bands or cords that form in the neck and excess fat. A neck lift is almost always combined with a facelift because the facelift incisions around the ear are necessary to remove the excess skin that forms in the neck with age. In younger patients with minimal excess skin, a submentoplasty or cervicoplasty may be performed as an isolated procedure, particularly when the problem is primarily excess fat, in such cases; submental liposuction is the best surgical procedure to remove the excess fat or double chin.

A direct neck lift or direct neck excision is typically reserved for men. It places incisions in the midline of the neck and is done to remove excess skin and fat as well as tighten the platysma muscles as necessary. Patients must understand that a direct neck lift will not address the heaviness or excess skin of the cheeks, and it involves an incision line in the neck. Consequently, men are much more suited for this type of neck lift procedure since they are typically less concerned with cheek fullness or jowls or with having an incision line in the neck.

Depending on the degree of the neck lift procedure needed to meet specific patient goals, a neck lift generally takes 10 to 14 days to heal in the short term. To ensure proper, expeditious recovery from a neck lift procedure, a compression bandage may be placed on you to help decrease post-operative swelling and facilitate healing in the neck area. Usually, this is worn day and night for about 5-7 days and nightly thereafter for another week. Bruising and swelling are usually resolved within 7 to 10 days. Patients can return to normal activity within 2 to 3 weeks. Minor neck lift procedures can be done in our office using local anesthesia.

A neck lift describes a variety of procedures, used alone or in conjunction with a facelift. The goal of any neck lift procedure (or combination of procedures) is always to improve the contour and appearance of the neck.
Depending on the areas of concern, the procedure may involve liposuction, direct excision of fat, tightening of muscle banding, and possibly skin removal. The goal is to re-contour the tissues underneath the chin and near the midline of the neck and reduce excess or sagging tissues in these areas.

The primary factor to determine which procedure is right for you is the amount of loose skin present and whether or not you are interested in correcting excessive sagging cheeks or jowls. Your specific needs, age and gender are what helps Dr. Stong tailor your specific neck lift procedure plan. The result will be a tighter, natural and more youthful neck appearance.

As a general guideline, Dr. Stong uses platysmaplasty and liposuction, when necessary, as part of his submentoplasty neck lift in younger patients or in women in conjunction with their facelift. A direct neck excision is reserved for men who just want to address the waddle of excess skin, fat, and muscle in the middle of their neck.

Younger patients in their thirties and early forties with the beginning signs of aging can benefit from a submentoplasty. These patients usually have minimal excess skin and also still have enough elasticity to contract following the necessary muscle work and fat removal. There is generally no skin or only a small amount of skin removed with a submentoplasty neck lift. Submentoplasty uses a small incision and can be considered a “mini-lift” as a stand-alone procedure. Submentoplasty can accentuate the jawline to create a more youthful and healthy appearance. Again, it is ideal for younger patients who still have elasticity or firmness in their skin and who do not need excess skin removed.

If there is a significant amount of excess skin or the patient is older, a submentoplasty is typically performed in conjunction with a facelift for the best results. It is common for a submentoplasty to be included in a facelift surgery. The additional benefit of the facelift surgery is that it also lifts the cheeks or jowls and removes the excess skin of the neck and cheeks, which is often the primary goal of many older patients who have more advanced signs of aging.

Using Dr. Stong’s advanced surgical techniques, a neck lift, particularly in women, can be synonymous with a facelift. By placing incisions around the ear, not only is the neck lifted but also the cheeks and jowls. In a deep plane facelift, which Dr. Stong performs almost exclusively, the upper cheeks and midface are also lifted as an additional benefit.
As mentioned previously, a submentoplasty is usually performed at the time of a facelift through a small incision underneath the chin. Muscle tightening and fat removal are performed as needed in the neck as part of the comprehensive neck lift and facelift. It is important to understand that if excess skin needs to be removed, it can only be achieved with long term benefit through a facelift incision after the neck lift portion of the procedure.